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Next-Generation Sequencing of Circulating Tumor DNA Can Optimize Second-Line Treatment in RAS Wild-Type Metastatic Colorectal Cancer after Progression on anti-EGFR Therapy : Time to Rethink Our Approach

Mauri, Davide (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Kamposioras, Konstantinos (författare)
Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
Matthaios, Dimitrios (författare)
Department of Oncology, General Hospital of Rhodes, Rhodes, Greece
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Tolia, Maria (författare)
Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, University of Crete, Heraklion, Greece
Nixon, Ioanna (författare)
Scottish Sarcoma Network (SSN) UK Chair NCRI HN Epidemiology and Survivorship Subgroup, The Beatson West of Scotland Cancer Centre, Glasgow, UK
Dambrosio, Mario (författare)
Department of Medical Oncology, Clinica San Carlo, Paderno Dugnano, Italy
Zarkavelis, Georgios (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Papadimitriou, Konstantinos (författare)
University Hospital of Antwerp, Antwerp, Belgium
Petricevic, Branka (författare)
Department of Hematology and Oncology, Klinik Ottakring, Vienna, Austria
Kountourakis, Pantelis (författare)
Medical Oncology Department, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
Kopecky, Jindrich (författare)
Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
Kuhar, Cvetka Grašič (författare)
Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
Popovic, Lazar (författare)
Medical Oncology Department, Oncology Institute of Vojvodina, University of Novi Sad, Novi Sad, Serbia
Chilingirova, Nataliya P. (författare)
Medical Oncology Clinic at Specialized Hospital for Active Treatment in Oncology, University Pleven, Sofia, Bulgaria
De Mello, Ramon Andrade (författare)
Department of Biomedical Sciences & Medicine, University of Algarve, Faro, Portugal; Precision Oncology Group, Federal University of São Paulo (UNIFESP), & Nine of July University (UNINOVE), São Paulo, Brazil
Plavetic, Natalija Dedic (författare)
Department of Oncology, University Hospital Centre Zagreb, University of Zagreb, School of Medicine, Zagreb, Croatia
Katsanos, Konstantinos (författare)
Department of Gastroenterology, University Hospital of Ioannina, Ιoannina, Greece
Mostert, Bianca (författare)
Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
Alongi, Filippo (författare)
Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Verona, Italy; University of Brescia, Brescia, Italy
de Bari, Berardino (författare)
Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland
Corradini, Stefanie (författare)
Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
Kampletsas, Eleytherios (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Gazouli, Ioanna (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Gkoura, Stefania (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Amylidi, Anna-Lea (författare)
Department of Medical Oncology, University of Ιoannina, Ιoannina, Greece
Valachis, Antonis, 1984- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology
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 (creator_code:org_t)
2022-01-09
2022
Engelska.
Ingår i: Oncology Research and Treatment. - : S. Karger. - 2296-5270 .- 2296-5262. ; 45:4, s. 216-220
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background: Management of Ras wild-type colorectal cancer (CRC) patients upon disease progression after the successful use of targeted treatment with anti-EGFR monoclonal antibodies and backbone chemotherapy remains a clinical challenge.Summary: Development of treatment resistance with prevalence of preexisting RAS mutated clones, RAS mutation conversion, truncation of extracellular receptor domains as well as HER2 and MET amplification are molecular events that can be difficult to follow without the use of sophisticated laboratory techniques. The clinical hurdle of re-biopsy and tumor heterogeneity can be overcome by the implementation of next-generation sequencing (NGS) to analyze circulating tumor DNA (ctDNA) and identify druggable mutations or recovery of RAS-wildness. In this opinion paper, we summarize with critical thinking the clinical approach to be followed after the failure of first-line treatment in Ras wild-type CRC tumors with the use of NGS. Rechallenge with anti-EGFR inhibitors, in case of persistent or recovery of RAS-wildness, and targeted approach of specific mutations (BRAF inhibitors), amplifications (anti-Her2 treatment), or fusion proteins (NTRK inhibitors) can by guided by the use of NGS. The use of NGS platforms for serial analysis of ctDNA is an important step to better understand the molecular landscape of metastatic CRC and guide clinical decisions.Key Messages: NGS should be considered a mainstay in clinical practice for the management of CRC patients and health authorities should consider reimbursing its use in the appropriate clinical settings.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Next-generation sequencing
Circulating tumor DNA
2nd-line
Targeted
Treatments
Metastatic colorectal carcinoma
Progression

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